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complaint against Raksha TPA

This is a discussion on complaint against Raksha TPA within the Medical Insurance forums, part of the Insurance category; Dear Sir, Iam employee of Indian Mercantile Co-op. Bank Ltd. & having corporate policy no. 080102/48/11/41/00000129 purchased from United India ...

  1. #16
    Unregistered Guest

    Unhappy Short claim pass against claim no. 5454111255524-Member ID-UIC5457IMCBL

    Dear Sir,

    Iam employee of Indian Mercantile Co-op. Bank Ltd. & having corporate policy no. 080102/48/11/41/00000129 purchased from United India Insurance Co. Ltd. for Medical facilities.

    My wife Mrs. Seema Agarwal had admited At Dr. O.P.Choudhrey Hospital Raibarely Rd. Lucknow on dt. 29th June 2011 due to Disease of A.G.E. / HTN and discharged on 2nd July 2011.

    I had summitted my mediclaim bills for reimbursement Rs. 13163/- ( Hospitalisation, Medicines,Pathology etc. etc.) but claim passed only Rs. 9113/-

    I am not comfirt for short claim pass by Raksha TPA. Mentioned hospital provided advance deposits of receipts Rs. 4000/-and charge as Room rent Rs. 5400/- and mention and certified in final bill rest amount had been recd. in cash. why you are deducting Rs.1500/- with remarks proper receipt not given.

    You were deducted Rs. 2250/- ( Bills of Adullt Diapers ) from medication charges, when this is part for the treatment of disease and recommended by concerned Doctors.

    You were deducted Rs. 300/- as other charges as like Rs. 100/- admission fees & Rs. 200/- misc. charges.

    I know very well that I am having cashless policy for medical treatment. If I have gone your mentioned cash less hospitals then my money was not expent a single penny, so why you were deducted the amount in my claim voucher.

    Please pay deducted amount immediately in my savings bank A/c no. 1182 with Indian Mercantile Co-op. Bank Ltd. Cantt. Road Branch Lucknow.

    Thanks.


    Jitendra Kumar Agarwal

    ( Senior Manager )

  2. #17
    bela kakkar is offline Junior Member
    Join Date
    Nov 2011
    Posts
    1

    Default

    Dear Sir,
    This is regarding the policy of Mr. Ajay Kakkar (mediclaim policy no ( national insurance company)- 354500/48/10/85000014745 claim reference no - 5822111264544.) I have been forwarding the papers of the policy since 8th August from Max Super Speciality Hospital, Saket, have been in touch with Raksha (Faridabad) Dr. Tarun, till date i am unable to understand the status of the policy claim . Kindly look into the matter and let me know about the exact status of the policy. (either reimbursement or denial for the same) asap.
    Thanks & Regards,
    Bela Kakkar

  3. #18
    v.p sharma Guest

    Default against claim

    Dear Sir,
    I Vrakash Sharma customer of your insurace company.From last one month i fight against for my claim.i submitted all my documents so, why your company gave me a claim.my policy no is.31010334100300020061.sir please give attention.
    thanking you,
    ved prkash sharma
    mob. no.9958775599,
    09958075599

  4. #19
    Unregistered Guest

    Default Worang Id Number

    I have been provided wrong ID number.

    Shrikant Singh

  5. #20
    Unregistered Guest

    Default Worang Id Number

    I have been provided wrong ID number.

    Shrikant Singh
    ph: 9958813039

  6. #21
    Mr G S Khurana Guest

    Default Claim against Health Insurance

    Dear Sir
    This is to inform you that i am hav Policy no. 310600/34/07/11/00003168 Hospilasation Policy/ Medicine Policying health insurance policy in favore of Mr Deepak singh Khurana and Mrs Pooja Khurana and Mrs pooja khurana has admitted in max Health care hospital i had sended all tghe bills and accounts copy but yet i am failed to receive claim yet
    Please do the need full ASAP

  7. #22
    Amitt is offline Junior Member
    Join Date
    Feb 2012
    Posts
    1

    Default

    my father was admitted in hospital and got operated for "surgery of genito urinary system". First Raksha tpa approved the amount and later they canceled it. When I contacted them they told me submit all the documents, once patient will get discharged, we will look into this. I submitted all the documents on 28 dec 2011 and now they had rejected my claim stating that ' claim denied on ground of exclusion clause'. When I spoke to dr in thunga (mumbai)hospital they advise me since the operation was an emergency , they have to approved amount. Am feeling very helpless and kindly advise me what would be my next step ? Many thanks





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